Trusted evidence. Informed decisions. Better health. Project Transform Special Session Cochrane Colloquium Vienna, October 2015

Agenda 01Overview - Julian Elliott 02Evidence Pipeline - Steve McDonald and Gordon Dooley 03Getting Involved - Anna Noel-Storr 04Task Exchange - Tari Turner 05Production Models - Tari Turner 06Wrap up - Julian Elliott

Starting point Internal challenges – and opportunities External challenges – and opportunities Our focus is on Content production People > Technology Bringing people and technology together for evidence production

Goal To significantly improve the long-term value and sustainability of Cochrane by piloting, refining and scaling-up innovations in content production.

Objectives To support Strategy to 2020: 1. More effectively harness the skills and enthusiasm of our contributors (Goal 4) 2. To more efficiently identify research and understand review currency (Goal 1)

Challenges Information retrieval Opportunities for new contributors Connecting contributors Ensuring quality content  Evidence Pipeline  Getting Involved  Task Exchange  Production Models

Project Executive Julian Elliott (Co-Lead), James Thomas (Co-Lead), Sally Green, Chris Mavergames, Steve McDonald, Anna Noel- Storr, David Tovey Project Team Clive Adams, Lorne Becker, Linn Brandt, Rachel Churchill, Agustin Ciapponi, Miranda Cumpston, Gordon Dooley, Ruth Foxlee, Demian Glujovsky, Toby Lasserson, Geraldine Macdonald, Sue Marcus, Rupert McShane, Charlotte Pestridge, Daniel Perez Rada, Gabriel Rada, Jessica Thomas and IKMD developers Team

Participate It is only with the involvement of the broader Cochrane community that we will be able to realise the opportunities presented by this work. Information Regular updates in the Cochrane Community and Cochrane Connect newsletters A website and group which will be kept up to date as the project progresses Regular webinars Workshops and presentations at major meetings Get involved Interaction with Cochrane groups, including executives, boards, review groups Opportunities to get involved in early testing and piloting Opportunities for computer scientists to get involved in the machine learning aspects of the project

Join us

Trusted evidence. Informed decisions. Better health. Evidence Pipeline James Thomas

Current challenges Finding relevant studies in a timely and reliable way.

Completed reviews RG specialist registers Search strategies Citation networks… …? Cochrane Evidence Pipeline CSS / CROWD

Randomly selected citations from Pregnancy & Childbirth Group compared with citations from other groups WILL IT WORK? Despite apparently very similar sets of most significant terms, the classifier performs well

Evidence Pipeline Using text mining and machine learning to identify the relevant Review Group for any new citation automatically. Does it work? These ROC curves show that it can!

Within the new CRS-Web interface, you can: Select the group that you’re interested in Specify the range of scores you want to list View the list of citations, ordered by their likely relevance

Summary Citations ‘triaged’ to most relevant Review Group based on ‘signatures’ and ranked according to likely relevance Links to Centralised Search Service and crowd sourcing component of Getting Involved Ultimately hope to offer bespoke service to individuals with defined topic areas See more at the Cochrane Exchange

Trusted evidence. Informed decisions. Better health. Getting Involved: creating Cochrane citizen scientists Anna Noel-Storr

Current challenges We struggle to provide potential contributors with meaningful ways to get involved Hello. Can I come in?

Current challenges Lack of choice

Current challenges Currently the main route to contribution is as an author on a Cochrane review

Current challenges Information-overload “Global scientific output doubles every nine years” [Nature News Blog, May 2014]

So wait a minute… We have people who want to help We have too much information/data to keep up

This is not new Would this approach work for Cochrane?

The Embase project Help us find the trials!

The Embase project “the distribution of small parts of a problem” A large batch of records identified from a very sensitive search for RCTs

The Embase project Since going live… 200,000+ citations 12,000+ RCTs signed up

The Embase project Feasible to recruit a ‘crowd’ High levels of accuracy Why do people do it?

Appetite “Read 'Bad Pharma' and wanted to help! ” “It feels good to be useful, because Cochrane is a prestigious organisation” “We continually use Cochrane reviews but don't get involved in producing them so Embase screening is a small way to contribute” “ To help out! It's a great cause” “it seemed such a great thing to be able to help out every time I had a few minutes to spare” “To help out and to put something back into the profession” “to do something useful ” “a desire to help the project. Crowdsourcing is cool ” I remain committed to evidence based practice and wanted to support it any way I could

Appetite “to maintain my skills ” “Better understand RCTs” to help out a little and gain some skills ” “To learn, practice and to make a tiny contribution!” “To learn ” “wanted to hone skills in identifying RCTs.” “to gain experience” “to help out with a really important project, but I am also learning at the same time. So it's really great” To learn and develop skills

Appetite “to maintain my skills ” “Better understand RCTs” to help out a little and gain some skills ” “To learn, practice and to make a tiny contribution!” “To learn ” “wanted to hone skills in identifying RCTs.” “to gain experience” “to help out with a really important project, but I am also learning at the same time. So it's really great” A stepping stone

Appetite “to maintain my skills ” “Better understand RCTs” to help out a little and gain some skills ” “To learn, practice and to make a tiny contribution!” “To learn ” “wanted to hone skills in identifying RCTs.” “to gain experience” “to help out with a really important project, but I am also learning at the same time. So it's really great” “to help myself to be familiar with evidence based medicine, and prepare myself for possible future work with Cochrane”

Getting Involved: more tasks At citation level RCT identification DTA identification RCT description

For each task: For each task we’re developing interactive training

In RCT identification we have a Help me decide feature

For each task: For each task contributors can set their preferences…

Preferences: offline working Setting personal targets

Preferences: filter by topic People will want to classify records of potential interest to them

Summary A model of contribution that brings benefits to contributor and to Cochrane Taking all that we learnt so far and scaling-up Complex, ambitious project not working in isolation (Centralised Search Service, Evidence Pipeline, Cochrane Membership, Linked Data) Phase 1 = development Phase 2 = pilot, refine, launch

Thank you To find out more: Workshop Monday 4 October 11-12:20 Help to filter the information overload for better decisions!

Trusted evidence. Informed decisions. Better health. Task Exchange

Aim To connect members of the Cochrane Community who want help with their reviews with people who have the skills and time to help.

taskexchange.cochrane.org “Airtasker for Cochranites” (but we reckon it’s prettier…)

Next steps For the developers: Second round of development October – December 2015 Beta release February 2016 For Cochranites: Sign up, load your profile, post and respond to tasks Today! Give us feedback At the workshop tomorrow or by any time:

taskexchange.cochrane.org A bigger team than you think

Trusted evidence. Informed decisions. Better health. Production Models Early findings from our exploration of current approaches to systematic review production

Background Production Models is one of the 4 components of Project Transform Aim is to identify, pilot and scale up new ways of producing Cochrane reviews that increase quality and timeliness. Led by Tari Turner (Australasian Cochrane Centre), under the guidance of David Tovey and Julian Elliott Started in July 2015

Voices 24 interviews MEs (6), Authors (6), External (5), CRG staff (3), CoEds (2), Editors (2) 90 online surveys Authors (37), MEs or CoEds (17), TSC (12), Consumers (11), Methodologist (10), Editors (4), Centre Staff (3), CEU staff (2), Other (8) Informal ‘rough-cut’ analysis

The unsurprising part Wide variety of approaches to review production between and within Review Groups It’s all about people Every review is unique & unpredictable “that’s the ‘collaboration’ bit of The Cochrane Collaboration... it’s all about the human relationships” “good people drive good processes” “treating review production like a factory is a mistake”

How are we producing reviews?... In every way imaginable! Emerging themes around: Author team requirements, structure and incentives Roles of Review Groups Shared challenges Approaches to improving the production process

Author Teams Team formation & task allocation are largely informal and organic Payment models vary –Fully paid teams, Outsourcing, Teams with paid members, Incentives & stipends, Fully volunteer teams –Having money helps, greater accountability, but doesn’t solve all problems Requirements vary, but agree importance of an effective leader –Tension between focus on capacity building and benefits of experienced authors –Challenge of sourcing timely clinical input & not wasting this time on tedium “Some people just get on and do it, and you can’t predict who will” “Things move along in a different way where there is a little funding for the review team to justify spending the time”

Roles of Review Groups Extent of project management varies widely –Active, hands-on management by a range of people –Hands-off –Sense of trend towards more hands-on management Variation in how CRGs see their role as & have challenges with providing clinical input, methodological guidance, editorial oversight Substantial issues with peer review processes “If you can find a Review Group where people are less hands-on than we are and are producing good reviews, I’d like to see it”

Shared challenges Conflation of review production (“the science”) and editorial processes (“the publication”) Increasing complexity of methods Difficulty keeping authors on board and on track The length of the process They are interrelated - no easy answers

Approaches to improvement Breaking reviews into chunks Standardising review content Truncated protocol processes Suites of reviews Increased specificity of searches Focusing on simple, reliable, useful reviews “ Very important to move on from thinking that everybody has to do every part of the review” “Go back to basics… Stop expecting complexity in all reviews”

Approaches to improvement Starting on the right foot Tightening title registration Extended protocol processes Author team requirements Widespread appetite for automation and software support “Make the routine part more automated so we can focus on the fun – remove the drudgery”

Next steps  Finalise data collection: November 2015  Complete analysis and report: February 2016  Identify/develop models to pilot: Feb – August 2016  Begin piloting: September 2016 “the more I work with Cochrane the more I think they’ve got it right”

If you’d like to find out more me or stop me in a corridor and offer to buy me a coffee